Study: Hospital Worker Flu Shots Could Result in Fewer Deaths

Nursing staff vaccination rates remain low.

Pneumonia and the flu kill tens of thousands of Americans each year, according to the U.S. Centers for Disease Control and Prevention, but new research from the University of Georgia (UGA) shows that state laws promoting flu vaccinations for hospital workers can substantially reduce the number of influenza-related deaths.

The 23-year study looked at the mortality rate from influenza and pneumonia during peak flu season—from December through March of each year—comparing changes in mortality in the 13 states and Washington, D.C., that had enacted laws requiring flu vaccines for identified categories of hospital workers to the changes in mortality in states without such laws.

All states that passed laws require the flu vaccines to be offered to hospital employees. Eleven states mandate that workers be vaccinated or require documentation of refusal, with three requiring unvaccinated employees to wear surgical masks during flu season.

Though the findings align with previous research suggesting that hospital workers may serve as vectors of disease transmission within their hospitals and even in their communities, vaccination rates remain low, particularly in nursing staff.

One study found three recurring main themes about why nurses decline the influenza vaccine:

• Concern about side effects and desire to maintain a "strong and healthy body"
• Protecting their "decisional autonomy"
• Perception of health authorities, pharmaceutical companies, and scientists as "untrustworthy"

In some cases, healthcare workers refuse to get vaccinated because flu shots vary in efficacy each year due to the limitation of vaccine developers only being able to include several strains of the virus in a given shot.

However, the American Academy of Nursing strongly recommends nurses protect both themselves and their patients by adhering to the recommended vaccine schedule for health professionals.

"To optimize the health and well-being of patients, their families, and the community, nurses must be fully vaccinated," according to an Academy position statement. "When nurses work directly with patients or handle fluids, they are more likely to get—and spread—infectious diseases."

States that mandated hospital workers receive flu shots saw the biggest reduction in mortality from flu and pneumonia. On average, the adoption of a law promoting vaccination reduced mortality by about two deaths per 100,000 persons, with the reductions primarily occurring among older adult populations.

"The elderly are extremely vulnerable to influenza and are also generally less responsive to the vaccine," said Emily Lawler, corresponding author of the study and an assistant professor in UGA’s School of Public and International Affairs. "This study suggests that vaccinating hospital workers against influenza reduces influenza disease transmission and helps protect this vulnerable population."

Vaccinating hospital workers would protect all populations, as well, she said.

"Stricter policies result in higher vaccination rates among healthcare workers," Lawler said. "Our results are consistent with the idea that these stronger laws result in a larger reduction in influenza-related mortality."